The operation

The surgeon will shine a microscope into the ear. He will pull the grommet out of the ear drum with a special instrument. Because your child is asleep, there will be no pain during the operation.

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The operation can be done as a day case. This means that your child comes into hospital on the day of the operation and goes home the same day.

Sometimes they may have to stay in the hospital for one night until the effect of the anaesthetic has completely gone.

When the grommet is out, there is a small hole left in the ear drum. This will usually close up on its own. The surgeon will check your child's ear drum in the outpatient clinic after about six weeks, to make sure that it is has done this.

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Any alternatives?

If you leave things as they are, the grommet may stay there for years. It could be difficult to get out if the delay is long.

All the time the grommet is in place, your child must not get water in the ears. Swimming and especially diving are not safe unless the ears are protected with ear plugs and a tight bathing cap.

Your child cannot have the ear syringed to remove any wax. It the grommet stays in too long there is an increased chance of your child getting and ear infection.

Although there is no rush to have the grommet taken out, your child would be better off without it.

Before the operation

Your child must have nothing to eat or drink for about six hours before the operation. This means not even a sip of water. Your child's stomach needs to be empty so that the anaesthetic can be administered safely.

If your child has a cold in the week before admission to the hospital, please telephone the ward and let the ward sister know. The operation will usually need to be put off. Your child has to get over the cold before the operation can be done because by having an anaesthetic the cold could turn into a serious infection in the chest.

Sort out any tablets, medicines, inhalers that your child is using. Keep them in their original boxes and packets. Bring them to the hospital with you.

On the ward, your child will be checked for past illnesses andwill have special tests to make sure that he or she is well prepared and can have the operation as safely as possible. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings.

You and your child will have the operation explained to you and you will be asked to fill in an operation consent form for your child. You will have the operation explained to you and will be asked to fill in an operation consent form.

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Before you sign the consent form, make sure that you fully understand all the information that was given to you regarding your child's health problems, the possible and proposed treatments and any potential risks. Feel free to ask more questions if things are not entirely clear.

Any tissues that are removed during the operation will be sent for tests to help plan the appropriate treatment. Any remaining tissue that is left over after the tests will be discarded.

Before the operation and as part of the consent process, you may be asked to give permission for any 'left over' pieces to be used for medical research that have been approved by the hospital. It is entirely up to you to allow this or not.

Many hospitals now run special preadmission clinics, where you visit a week or so before the operation, where these checks will be made.

After – in hospital

Usually there is little or no pain after this operation. If there is any discomfort in the ear, paracetamol in liquid form should easily control it.

A general anaesthetic may make your child slow, clumsy and forgetful for about 24 hours. While in hospital, the nurses will support you to help your child until he or she feels better.

Before you leave the ward, the nurses will give you an appointment to come to the ENT (ear, nose and throat) outpatient clinic in six weeks or so for the surgeon to check your child's ear drum.

The surgeon in the outpatient clinic will tell you if the hole in your child's ear drum has healed. He will let you know if it will be safe for your child to swim again without any special protection for the ear.

After – at home

After three to four hours on the ward, your child should feel fit enough to go home.

The doctors will check that your child's ear is comfortable and is not bleeding.

It is important that your child still keeps the ear dry. Any water in the ear may go through the hole in the ear drum and cause an infection. Plug the ear with a piece of cotton wool rubbed in Vaseline at bath times, or when washing your child's hair.

He or she should not go swimming unless the ear is properly protected with ear plugs and a tight bathing cap.

Possible complications

As with any operation under general anaesthetic, there is a very small risk of complications related to the heart and the lungs.

The tests that your child will have before the operation will make sure that he or she can have the operation in the safest possible way and will bring the risk for such complications very close to zero.

If you follow the advice given above, you are unlikely to have any problems.

There is a very small risk that your child's ear may bleed when you get home. If this happens, come back to the ward. It should usually stops fairly soon, but you may find that the doctor needs to put a cotton plug in your child's ear and apply some pressure until the bleeding stops.

There is also a very small possibility for an ear infection. If this happens, you will notice some fluid coming out of the ear (with a bad infection this can be thick, green and or yellow and smelly) and your child might have a headache or temperature. The infection usually settles by taking antibiotics for a week or so.

Sometimes the infection can be much more serious and spread through your child's blood or even towards the brain. If this is the case your child will need to stay in the hospital and have intravenous antibiotics (through a vein in their arm).

In 2 to 3 per cent of children, the small hole in the ear drum may not close up after six weeks. Given more time, most of these close on their own without any treatment. A few need to be closed with another operation.

The grommet insertion operation is successful for 70 per cent of children who have it. The remaining 30 per cent may need a grommet reinserted on one or more occasions because fluid builds up again at a later date.

General advice

These notes should help you and your child through the operation. They are a general guide. They do not cover everything. Also, all hospitals and surgeons vary a little.

If you have any queries or problems, please ask the doctors or nurses.

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.